Provider Demographics
NPI:1023346921
Name:HARDY, KIMBERLY M (PHARM D)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:HARDY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 S. IH 35
Mailing Address - Street 2:WALMART 0475
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-244-9051
Mailing Address - Fax:512-310-1326
Practice Address - Street 1:2701 S IH 35
Practice Address - Street 2:WALMART 0475
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-244-9051
Practice Address - Fax:512-310-1326
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX42738183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist